Med Admin - Large Slides

What are the three routes of administratinon?

Enteral: absorbed by GI tract

Injected into body part

Bypassing GI tract

What med routes are enteral and are absorbed by the GI tract?

• by mouth

• per tube

What med routes bypass the GI tract?

• inhaled

• topical

• sublinguial

• transdermal

What routes are more vascular and thus have more rapid absorption?

• Intravenous

• Intramuscular

• Sublingual

What routes have variable absorption?

• oral - depends on what you’ve eaten and other meds taken

• transdermal - depends on temp

What medications are metabolized by the GI tract?

Enteral

• PO - med swallowed by mouth

• Per tube - bypasses esophagus and delivered directly to stomach and small intestine

  • Ex: NGT or Dobhoff, J-tube

What is sublingual?

Under the tongue

What is buccal?

Between the cheek and gum line

How do sublingual and buccal meds enter the body?

They bypass the GI tract and liver and directly enter the bloodstream via vasucalr tissue in cheek and under the tongue

Are sublingual/buccal meds rapid acting or slow?

Rapid acting

Decscrribe subcutaneous injections

• moderate blood supply/intermediate absorption rate

• outer upper arms, abdomen, anteriro thigh

Describe IM injections

• highly vascular/fast absorption rate

• Deltoid, vastus lateralis, ventrogluteal

Which injection site has the slowest rate of absorption?

Intradermal

What is the max volume that can be injected intradermally?

0.1mL

What is the max volume that can be injected Sub-Q?

1.5mL

What is the max volume that can be injected IM via ventrogluteal?

3mL

What is the max volume that can be injected IM via vastus lateralis?

1-3mL

What is the max volume that can be injected IM via deltoid?

2mL

All of the IM injections can be given at what angle?

90 degrees

What angle can SQ injections be given?

45-90 degrees

What angle can intradermal injections be given?

15 degrees

IM needles have what needle length and gauge?

5/8 to 1.5” with 18-25G

SQ needles have what needle length and gauge?

3/8-5/8”, 25-27 G

Intradermal needles have what needle length and gague?

1/4-5/8” 25-27G

Should the bevel be down or up when injecting?

Up

Where are intradermal injections given?

Forearm - pull skin taut

• TB skin test, allergy testing

• 15 degree angle

• Creates a “bleb”

Where are sub-q injections given?

• front of thigh

• lower abdomen

• side or back of upper arm

need adequate adipose tissue

Describe IM injection of Deltoid

• max volume is 2mL

• Inject center of muslce

• 90 degree angle

• 3-5 cm below acromion process

Describe IM injection of Vastus lateralis

• preferred site up to age 3

• max volume 1-3 mL

• Inject middle 1/3 of muscle

• 90 degree

Which IM site is primarily for children and babies?

Vastus lateralis

Which IM site can hold the largest volume?

Ventrogluteal

Describe IM injection of Ventrogluteal

• Inject within V

• Max volume 3 mL

• 90 degrees

Which IM injection has the lowest risk of nerve damage?

Ventrogluteal

When giving otic medication to adults, you should pull the auricle which way?

Up and back

When giving otic medication to children you should pull their auricle what way?

Down and back

When giving nasal spray how should the pt’s head be positioned?

Pt should be in high fowler’s with head tilted forward

• aim tip toward lateral side of nostril toward back of head and occlude other nostril

• avoid blowing nose 5-10 min after admin

When giving nasal drops how should the pt’s head be positioned?

Pt should be supine with their head tilted back

• place dropper 1cm above nostril

• remain supine for 5 min after

• avoid blowing nose 5-10 min after admin

Nurses should insert a rectal suppository how many inches?

4 inches

• pt should stay in on left side for at least 5 min after administration and avoid passing stool for >20 min

What is the technique for using inhaled meds?

• Shake inhaler

• Take deep breath and fully exhale

• Insert mouthpiece and close lips tightly with canister in upright position

• Depress canister while inhaling slowly for 3-5 sec

• Hold breath for 5-10 sec